12
PET OWNER EDUCATIONAL ATLAS. CATS
GUIDELINES
6
Pain scale according to facial expression (grimace scale) This scale enables recognition of acute pain in cats, including those that have been sedated with acepromazine/buprenorphine and are recovering from anaesthesia. It is based on a study conducted in 2020 (Clinical applicability of the Feline Grimace Scale).
How to use the scale Four sites on the face are evaluated: the ears, eyes, whiskers, and cheeks. Each site on the face is scored 0, 1, or 2, and the total score is summed: ■ Score <4: indicative of no pain. ■ Score ≥4: immediate analgesia required. ■ Score of 8: intense pain. The cat should be reassessed to verify the efficacy of the analgesia used.
Score of 0 (no pain): ■ ■ ■ ■
Ears forward. Rounded eyes. Relaxed muzzle (round). Whiskers curved downwards.
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0 = absent
1 = moderately present
2 = markedly present
Ears forward
Ears slightly pulled apart
Ears flattened
Rounded eyes
Eyes slightly closed
Squinting eyes
Whiskers curved downwards
Whiskers straight or curved upwards
Whiskers straight and separated
Relaxed muzzle (round)
Muzzle slightly tense
Tense muzzle (elliptical)
Score of 1 (moderate pain): ■ ■ ■ ■
Ears slightly pulled apart. Eyes somewhat closed. Muzzle slightly tense. Whiskers straight or curved upwards.
Score of 2 (severe pain): ■ ■ ■ ■
Ears flattened. Squinting eyes. Tense muzzle (elliptical). Whiskers straight and separated.
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MAIN CONDITIONS BY SYSTEM
23
RENAL AND URINARY SYSTEM
17 Techniques for resolution
of ureteral obstruction
Currently there are three techniques used to resolve ureteral obstruction: ureterotomy, endoprosthesis (stent), and subcutaneous bypass. All have their advantages and disadvantages.
Ureterotomy ■
■
■
■
Using this technique, the ureter is dissected and the calculus is removed. This is performed if there a single obstruction located in the proximal third of the ureter. Advantages: definitive technique that avoids the persistence of materials that cause infections or migrations. Complications: leaks, stenosis, re-obstruction.
Subcutaneous ureteral bypass (SUB)
Renal catheter Obstructed ureter
Subcutaneous tissue Access port
Calculus inside the ureter
Bladder catheter
Endoprosthesis (stent) ■
■
■
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Consists of placing a guide that passes through the ureter, from the bladder to the interior of the renal pelvis. This guide runs parallel to the calculi. This is achieved by open surgery or by endoscopy in females. Complications: ureteral rupture during the procedure, dysuria, haematuria, urinary infections, stent migration, calcification.
■
■
This is a device that “bypasses” the ureter by creating a new tube from the affected kidney to the bladder. Part of its route runs outside the abdomen, in the subcutaneous plane.
Advantages: ■
Allows urine samples to be taken from the renal pelvis for culture.
Complications: ■
■
Short-term: leaks, semi-obstruction due to bent catheters or clots, bleeding during nephrostomy. Long-term: recurrent infections, dysuria, occlusion due to mineralisation, kinked catheters.
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PET OWNER EDUCATIONAL ATLAS. CATS
REPRODUCTIVE SYSTEM
24 Residual ovary syndrome This syndrome should be suspected when cats continue to show signs of heat after sterilisation. Surgical treatment is required to locate and remove the remaining ovarian tissue.
Causes ■ ■ ■
Presence of ectopic ovarian tissue. Autotransplantation of ovarian tissue. Failure of the surgical procedure.
Diagnosis ■ ■ ■ ■
■
Presence of the usual signs of heat. Vaginal cytology during clinical signs compatible with oestrus. Chorionic gonadotropin stimulation test. Diagnostic imaging: ultrasound will enable detection of ovarian tissue, which will be hypoechoic and contain cystic structures. However, failure to detect tissue does not rule out its presence. Exploratory or laparoscopic laparotomy.
Exploratory laparotomy and laparoscopy allow diagnosis and treatment by removing ovarian tissue. Posture typical of cat in heat, with the anterior third lowered and the posterior third raised
The tail is lifted and moved to display the area of the vulva Purring and meowing increase
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MAIN CONDITIONS BY SYSTEM
61
DENTISTRY
55 Periodontal disease Periodontal disease is a condition caused by bacteria. It consists of two phases: 1. Gingivitis: initial phase caused by the accumulation of bacterial plaque (bacteria in biofilm) on the teeth over hours or days. Subsequently, the biofilm mineralises to form calculus (tartar). These bacteria provoke an inflammatory response leading to inflammation of the gums. Treatment during this phase is curative. 2. Periodontitis: due to chronic inflammation and the increased deposition of bacteria, the tissues that support the tooth are irreversibly damaged, and ultimately the tooth is lost. Treatment does not repair the damaged tissues, but can prevent loss of the tooth.
Stages PHASE 1. Gingivitis. Gum
PHASE 2. Loss of 25 % of alveolar bone.
Bacterial plaque
Periodontal bone
PHASE 3. Loss of 25–50 % of alveolar bone.
PHASE 4. Loss of >50 % of alveolar bone.
Treatment Gingivitis: ■ ■
Dental cleaning and polishing in the clinic to remove calculus (tartar). Control of dental plaque at home by brushing and using toothpaste.
Periodontitis: ■ ■ ■ ■
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Frequent dental cleaning and polishing. Dental radiographs to assess severity. Gingivectomy. Extraction of severely damaged teeth.
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PET OWNER EDUCATIONAL ATLAS. CATS
80 Urethral catheterisation
and cystocentesis
Urethral catheterisation ■
■
■
This is performed in cases in which urethral obstruction occurs (the cat is unable to urinate). It consists of the introduction of a catheter through the penis into the bladder, generally for a maximum of 24–48 hours. It always requires anaesthesia and intensive analgesic treatment.
Cystocentesis ■
■ ■ ■
For the diagnosis of urinary infections it is necessary to obtain a sample by cystocentesis. This consists of puncturing the bladder with a fine needle. It is a painless procedure. The urine sample obtained will be sent in sterile conditions for culture and an antibiogram.
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